What the Glycomark Test Can Tell You About Your Heart Health

5 minutes read

There are several ways to measure and understand your glucose levels, each with different benefits and limitations. For example, an A1C test gives you a picture of your average glucose over a few months but fails to capture the variability of day-to-day glucose fluctuations.

While the A1C test can be a good starting point for learning more about your health, other methods of evaluating metabolic health offer more insights and nuance into what’s happening inside your body.

A new lab test, called the glycomark test, may offer a better method of capturing post-meal glucose variability and provide a new and more reliable way of evaluating the risk of cardiovascular disease. Here, we’ll talk about everything you need to know about the test itself, what it can and can’t show you, who should get one, and more.

What is the glycomark test?

A glycomark test evaluates the amount of glucose spikes a person has had in the past 1-2 weeks. It gives insight into blood glucose variability that A1C does not, allowing both healthy people and people with diabetes to understand if their blood glucose is becoming dysregulated and/or requires better management.

The test requires a blood draw and evaluates the levels of 1,5-anhydro-d-glucitol in the bloodstream. The biomarker 1,5-anhydro-d-glucitol, or 1,5 AG, is a type of simple sugar that is present in most foods.

In cases of normal health, levels of 1,5 AG in the bloodstream remain relatively consistent. You ingest the simple sugar 1,5 AG when you eat, and it is distributed throughout the body, ultimately reabsorbed by the kidney [1]. This allows the body to maintain homeostasis, or balance, of 1,5 AG levels, keeping them steady and without fluctuation.

However, in the event of high blood glucose, the kidney will prioritize the reabsorption of glucose in an attempt to lower blood sugar levels and protect your health. In these instances, 1,5 AG is not reabsorbed correctly, and instead excreted in urine, leading to lower levels of 1,5 AG in the blood. Researchers discovered low levels of 1,5 AG were common in diabetic patients, leading them to realize that testing for this biomarker could help them better understand blood sugar fluctuations, specifically high blood sugars [2].

Normal glycomark levels are 10 μg/mL or above, while anything below 10 μg/mL is a sign of frequent high blood sugar spikes after meals [3].

Beyond this, high blood sugar can cause inflammation and vascular damage, linked to plaque buildup in arteries. Because of this connection, the glycomark test is also being investigated as a test for cardiovascular disease risk [4, 5].

The key takeaway is that while an A1C test gives you average blood glucose, the glycomark test gives you a short-term look at your glucose variability, a key indicator of metabolic health [6].

Who should get a glycomark test?

The glycomark test functions best for people with diabetes, as 1,5 AG levels begin to become affected after glucose fluctuations of 160-180 mg/dL (8.9-10 mmol/L) [7]. However, metabolic health is a spectrum, and just because you are not currently diabetic does not mean that your metabolic health may not be at risk.

If you have seen your A1C increase recently or have other metabolic health risk factors, it may be wise to get a glycomark test along with your next A1C test. If you are at risk for or have cardiovascular disease, and have not yet been managing your blood glucose levels with a CGM, glycomark may be useful to better understand how your blood sugar is fluctuating and what steps you should take to manage it.

Glycomark vs. A1C vs. CGM

The glycomark test is a newer metric that measures glucose fluctuations after eating, and can show us if our post-meal glucose has been too high in the past few weeks. As mentioned, this test couples nicely with an A1C test since an A1C test gives you an average glucose reading for the past 2-3 months.

By looking at your average glucose via A1C and your short-term variability via the glycomark test, you’ll gain a clearer picture of you’re metabolic health, as well as your cardiovascular health.

However, you are still missing that minute-to-minute data that a CGM provides and the specific clarity of where abnormal glucose patterns are occurring, why they are occurring, and what you can do to rectify them. If you have an A1C that is elevated or bordering on prediabetes, as well as low glycomark, this may be an indicator that a CGM is a good idea for you, so you can start monitoring your metabolic health more closely.

What can the glycomark test tell you about your heart health?

Metabolic health and cardiovascular health are inextricably intertwined. In diabetic patients, some research has shown that A1C levels are associated with poor cardiovascular outcomes and heart attacks. However, for non-diabetics with heart conditions, A1C has been shown to be less useful as a measure of heart health outcomes, as it is too broad a time frame to understand specific changes in heart health [8].

Recent studies have shown evidence that glycomark may be more valuable than both A1C and average glucose levels for determining the risk of cardiovascular disease in nondiabetic patients, and there has been research to suggest that glycomark may be a helpful indicator of dangerous plaque buildup in arteries that can lead to heart attacks [9, 10].

Since research into glycomark for diagnosing cardiac health markers is in its infancy, there is not a large clinical movement to use glycomark instead of A1C to understand heart health. That said, if you are someone who has diabetes and at risk for/have heart complications, you may want to ask your doctor for a glycomark test. If your results are low, you are experiencing frequent glucose spikes, and a CGM would be a helpful next step for monitoring and managing your glucose levels.

What can you do about your glycomark test results?

If you get a lab test and your glycomark test comes back low, you’re having frequent glucose spikes after meals. Some of the best ways to curb glucose spikes and keep glucose levels stable are as follows:

Increase fiber and protein intake at meals. Fiber is an indigestible carb that comes from plant matter and slows glucose absorption into the bloodstream. This curbs glucose spikes and keeps you feeling full. Protein has a negligible effect on glucose levels, keeps you satiated, and supports lean muscle mass. Both protein and fiber are great for stable glycemic control. To get more fiber, eat leafy greens, vegetables, berries, and whole grains. Try poultry, lean grass-fed beef, salmon, tuna, tofu, or seitan for lean protein.
Go for post-meal walks. The power of a post-meal walk can’t be overstated. Walking as little as 2 minutes after a meal can curb glucose spikes, but we recommend 15-30 minutes for best results [11].
Get enough sleep. Sleep is crucial to stable glucose levels, and insufficient sleep or disrupted sleep can lead to more glucose fluctuations the following day. Try to stick to a bedtime and waketime routine, and make sure sufficient sleep is a priority.
Manage stress. Health issues can be stressful, and unfortunately stress can cause elevated glucose levels. Manage stress levels with deep breathing, yoga, meditation, or therapy to improve mental well-being and limit high blood sugar.
Try a CGM: CGMs are not just for diabetics. With a CGM, you’ll learn which areas of your health and habits need work, and which are serving you well. With a CGM and the Veri app, you can track your glucose and see how food, exercise, sleep, and stress impact your levels, and receive guidance on how to take action toward better health.

Key takeaways

An A1C test gives you a snapshot of your average blood glucose, while the glycomark test gives you a short- term look at your glucose variability, which is a key indicator of metabolic health.
The glycomark test can be an indicator of plaque buildup in arteries as well as cardiovascular disease risk.
Normal glycomark levels are 10 μg/mL or above, while anything below 10 μg/mL is a sign of frequent high blood sugar spikes after meals.
The glycomark test is best for people with diabetes, but if you’re at risk for cardiovascular disease or have other metabolic health risk factors, pairing glycomark results with A1C results can give you a well-rounded picture of your health.
If you get your glycomark results and notice high glucose variability, you can make targeted lifestyle changes based on our Four Pillars and use a CGM to track glucose levels.

References:

Written by: Emily Johnson, MSc RD

Reviewed by: Dr. Vimal Ramjee, MD, FACC

Table of Contents

What is the glycomark test?
Who should get a glycomark test?
What can the glycomark test tell you about your heart health?
What can you do about your glycomark test results?
Key takeaways

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